Rahmah Nunung Nur, Horiuchi Tetsuyoshi, Kusano Yoshikazu, Seguchi Tatsuya, Hanaoka Yoshiki, Aoyama Tatsuro, Hongo Kazuhiro
Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto 390-8621, Nagano, Japan.
Neurol Med Chir (Tokyo). 2013;53(4):213-6. doi: 10.2176/nmc.53.213.
Cerebral perfusion monitoring is an important component of hyperacute stroke treatment. Arterial spin labeling (ASL) perfusion magnetic resonance (MR) imaging provides a noninvasive method of cerebral perfusion observation. Rapid changes in cerebral perfusion were demonstrated in two patients admitted one hour after onset of hyperacute stroke who underwent recombinant tissue plasminogen activator (rt-PA) treatment. Serial MR images and ASL images were taken on admission and after rt-PA administration. Cerebral blood flow (CBF) values were obtained using the CBF workstation and analysis software. Interpretable ASL images were taken in both patients. Perfusion deficits were consistent with symptoms and/or MR angiography imaging abnormalities. Delayed arterial transit effect was present in one patient; serial imaging showed improvement of CBF after rt-PA treatment in both patients. ASL perfusion MR imaging can provide rapid noninvasive multislice imaging in hyperacute ischemic stroke, and can depict early perfusion deficit and quantify regional CBF concomitantly.
脑灌注监测是超急性卒中治疗的重要组成部分。动脉自旋标记（ASL）灌注磁共振（MR）成像提供了一种无创的脑灌注观察方法。在两名超急性卒中发病后1小时入院并接受重组组织型纤溶酶原激活剂（rt-PA）治疗的患者中，观察到脑灌注的快速变化。在入院时和给予rt-PA后拍摄了系列MR图像和ASL图像。使用脑血流量（CBF）工作站和分析软件获得CBF值。两名患者均获得了可解释的ASL图像。灌注缺损与症状和/或MR血管造影成像异常一致。一名患者出现延迟动脉通过效应；系列成像显示两名患者在rt-PA治疗后CBF均有改善。ASL灌注MR成像可在超急性缺血性卒中中提供快速无创的多层成像，并可同时描绘早期灌注缺损并量化局部CBF。
